Late survival after heart transplantation: are we getting better at long-term management?

migration of these cells to the site of inflammation. Recently single nucleotide polymorphisms (SNPs) in some chemokine receptors have been shown to alter leukocyte recruitment and have been linked to atherosclerosis. We therefore analyzed their importance in a cardiac transplant recipient (CTR) cohort and their association with transplant vasculopathy (TV). Methods: 84 patients were enrolled from our heart transplant clinic. The following SNPs were genotyped: CX3CR1 V249I and T280M, CCR2 V64I and CCR5 A59029G. In 48 CTR two or more angiograms were available to compare transplant vasculopathy (TV) development: 25 subjects were judged to have TV. Mean time from transplant was 7.3 2.8 years. Results: The frequencies of the SNP alleles were in accordance with published data. Demographic data and pretransplant diagnosis were not significantly different among the SNP genotypes. The table shows significant associations with TV for the variant alleles CX3CR1 I249, CX3CR1 M280 and CCR2 I64. In conclusion, common SNPs of the genes encoding the receptors of fractalkine and MCP-1 may have a pathogenic role in the development of TV. The likely mechanism underlying these associations is a modified leukocyte-graft interaction in the vessel wall. Further research is needed to replicate the associations and to establish these mechanisms.